In current medical practice, wounds and ulcers are usually irrigated and washed with either tap water, sterile distilled water or sterile normal saline solution, which is generally made isotonic with human plasma by concentration of primarily sodium chloride at a level of approximately 0.9 weight percent and with solution pH of less than about 6. It has now been learned that while such normal saline solution is an effective bacteriostatic/bactericidal agent, such solution can be a long-run detriment to the well-being of the tissue cells because they slow down or prevent healing of the wound.
As described in U.S. Pat. No. 3,812,252 which is incorporated by reference herein, a particularly effective healing treatment for wounds and skin defects such as burns, ulcers and leisions is the application of a medicinal dressing containing as an essential ingredient starch hydrolysate having Dextrose Equivalent of less than about 35. In such wound treatment the starch hydrolysate produces the formation of a film which is intimately adhered to the underlying granulation tissue and which is semipermeable to gas and fluids and provides an ideal protective cover that will reduce fluid and plasma losses and invasion by pathogenic bacteria. In addition, it appears that the starch hydrolysate provides a topical or local hyperalimentation, that is local nutrition, providing a gradual release of glucose which is particularly effective in nutrition of tissue, both damaged and nascent, which have become relatively isolated from normal blood flow nutrition. The cessation of blood flow to such an ischemic leision can be developed in a slow and gradual form such as in the case of decubitius ulcers and statis ulcers, or may take place more acutely such as in thermo-radiation and chemical burns. In the absence of nutrition such as provided by the treatment with starch hydrolysate, the decrease in the rate of fluid delivery of nutrients brings a progressive impairment in the viability of cells and tissues which eventually leads to degeneration and death of the tissue and cells in a condition known as necrosis which is generally accompanied by bacterial, fungal, and/or viral contamination and proliferation. As further pointed out in the aforementioned patent, treatment of exudative skin wounds with a starch hydrolysate dressing produces a greatly reduced bacteria count of an infected wound and inhibits infection of an uninfected wound. In addition, application of the starch hydrolysate to a wound or ulcer produces a film or semi-permeable membrane which allows edemic liquid to pass through while proteinaceous material is retained within the body, allowing reduction in the volume of exudate in relatively clean condition. In addition, the patent teaches nutritive agents, such as the amino acids, cystine and cysteine, and vitamins such as ascorbic acid (vitamin C) may also be mixed or applied along with particulate starch hydrolysate to promote the formation and growth of healthy granulation tissue.
In accordance with this invention, improvements in the starch hydrolysate treatment of wounds have been developed to provide irrigative treatment of the wound, effective to promote the healing process, as well as beneficial compounding of the starch hydrolysate material.